Exhibit B _ Certificate of Minority Form.docx

This is a Certificate of Insurance and Minority Status form for Exhibit E J-477 Renovations for Student Success and Career Services at Abraham Baldwin Agricultural College in Tifton, Georgia. The form requires applying firms and associated firms to provide professional liability insurance information, including the name and address of the insurance carrier, coverage amounts, and deductible amounts per claim. Firms must also declare their minority business status, with options to indicate whether they qualify as a Minority Business Enterprise (MBE), Women Business Enterprise (WBE), or other designated status.

The form requires notarization and must be completed with the applying firm's signature, the notary public's signature and seal, and the notary's commission expiration date. This document serves as a standard certification requirement for firms bidding on the project, ensuring compliance with insurance requirements and enabling the identification of minority-owned businesses participating in the contract opportunity.